J2468 HCPCS code: Injection, palonosetron hydrochloride (posfrea), 25 micrograms
J2468 is the HCPCS Level II code for injection, palonosetron hydrochloride (posfrea), 25 micrograms. In 2024 Medicare paid an average of $46.72 per service for J2468 across 16,420 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 10 per day on DME suppliers. In 2024, about 136 clinicians billed Medicare for J2468 for 657 beneficiaries; California, Arkansas, Nebraska accounted for 62% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2024-07-01 |
| Last action effective | 2025-01-01 |
Who bills J2468 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 136 |
| Medicare beneficiaries | 657 |
| States with claims | 8 |
| Share of services in top 3 states (California, Arkansas, Nebraska) | 62% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2468, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 16,420 | 657 | $58.63 | $46.72 |
States with the most J2468 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 3,600 | $46.69 |
| Arkansas | 3,437 | $52.88 |
| Nebraska | 2,720 | $36.24 |
| Alabama | 2,081 | $46.88 |
| Ohio | 1,830 | $46.83 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 10 | Prescribing Information |
| outpatient hospital claims | 10 | Prescribing Information |
| practitioner claims | 10 | Prescribing Information |
What changed for J2468
- 2024-07-01: J2468 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J2468?
J2468 is the HCPCS Level II code for injection, palonosetron hydrochloride (posfrea), 25 micrograms. Short descriptor: "Inj, palonosetron (posfrea)".
How much does Medicare pay for J2468?
In 2024, the average Medicare payment was $46.72 per service (average allowed $58.63).
Does Medicare cover J2468?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2468 can be billed per day?
10 on DME suppliers; 10 on outpatient hospital claims; 10 on practitioner claims (NCCI medically unlikely edits).
Related J24 codes
- J2400 — Injection, chloroprocaine hydrochloride, per 30 ml
- J2401 — Injection, chloroprocaine hydrochloride, per 1 mg
- J2402 — Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg
- J2403 — Chloroprocaine hcl ophthalmic, 3% gel, 1 mg
- J2404 — Injection, nicardipine, 0.1 mg
- J2405 — Injection, ondansetron hydrochloride, per 1 mg
- J2406 — Injection, oritavancin (kimyrsa), 10 mg
- J2407 — Injection, oritavancin (orbactiv), 10 mg
- J2410 — Injection, oxymorphone hcl, up to 1 mg
- J2425 — Injection, palifermin, 50 micrograms
- J2426 — Injection, paliperidone palmitate extended release (invega sustenna), 1 mg
- J2427 — Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J2468
- Watch J2468 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2468
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.